Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Yolk sac tumor (YST) of the stomach is extremely rare, with only several cases reported in the English literature. We present a case of primary gastric yolk sac tumor with liver metastases in a 66-year-old male. Preoperative diagnosis was poorly differentiated as adenocarcinoma of stomach. A total gastrectomy was performed. The tumor, with a maximum size of 6.0 cm, was composed microscopically of neoplastic cells with pale eosinophilic cytoplasm. Tumor cells were arranged into solid and papillary structures with several Schiller-Duval bodies. Other components of germ cell tumors, such as embryonal carcinomas and choriocarcinoma, were not identified. The tumor cells were positive for AFP, СÐ�? 18, СÐ�? 20, SALL4, glypican3, but were negative for PLAP, OCT �?¾, СÐ�? 7 by immunohisochemistry. The surgical margins were histologically negative, 12 of 22 resected lymph nodes had metastases. The laboratory findings showed high serum levels of AFP (2502ng/mL); testicles were symmetric with normal size. Primary pure gastric yolk sac tumor is a very rare entity. The rarity of gastric YST makes this diagnosis complicated. However, awareness of this unusual entity and its distinctive immunohistochemical profile invariably leads to a correct diagnosis.

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